Heartwarming moment

South African doctor, Prof Christiaan Barnard performed the world’s first heart transplant operation in Cape Town on December 3, 1967. Considered a medical miracle at the time, 50 years on, Sri Lankan doctors last week performed the country’s first heart transplant giving renewed hope to patients suffering from heart failure in the country.

Through the groundbreaking surgery, a 36 year old woman from Anuradhapura, suffering from cardiomyopathy was given a new lease of life. A feat which was possible only through the untiring efforts of an expert medical team and more importantly, through the ultimate sacrifice and kindness of two parents.

A parent’s sacrifice

For I.G Nandasena and his wife, it was perhaps the most difficult decision they had made during the course of their lives. Their son, 25 year old Pradeep Kumara Sampath was the unfortunate victim of a serious road traffic accident. Admitted to the ICU of the Kandy Teaching Hospital just over a month ago with severe injuries, the doctors had to declare him brain-dead and explain the tragic circumstances to his parents who were expecting the eventual recovery of their child.

“The doctors made every effort possible to save my son,” says Nandasena while recalling the accident that resulted in not only the death of his child but made way to give an opportunity of life to several other critical patients.

According to Nandasena, on the fateful day his son had left home on a motorcycle along with a relative. “He met with an accident on the way back when the bike collided with a van that had arrived in our village for a dengue awareness program” he says, adding that Pradeep was only a few feet away from reaching home when the accident occurred.

Nandasena says, despite the treatment the doctors later explained that his son would never recover. “The doctors explained to us that he was brain dead and would die once he is taken off the life support machine,” he recalls emotionally. According to Nandasena, however, the doctors also explained that Pradeep’s vital organs could be donated to critical patients and would help save their lives.

“I felt it was a merit for my son by which he will not face a similar untimely death in his next life,” Nandasena says explaining that therefore, he consented to donating his son’s organs including his heart for the transplants.

According to Nandasena, despite his son’s death he feels that his son is yet alive. “My child’s heart is still beating so I don’t feel he has left us,” he says tearfully. Despite losing their only son, Nandasena and his wife say they have found consolation by watching others being given a chance at life through the sacrifice made.

New lease of life

While several of the youth’s organs were donated, including his kidneys and eyes, it was the donation of his heart that allowed for the first heart transplant surgery in the country to take place.

The fortunate recipient was a 36 year old mother of one, from Anuradhapura.

According to Dr. Saman Ratnayake, Director, Kandy Teaching Hospital, the recipient had been suffering from Cardiomyopathy. “Without a transplant her condition would have led to her eventual death,” he explains, adding that it was revealed the donor heart was in fact a perfect match to the recipient.

Further elaborating on her condition, a cardiologist attached to the Anuradhapura Teaching Hospital, Dr. Roshan Paranamana, said, the recipient had first visited the hospital about three years ago.“She complained of breathing difficulties at the time,” he says, adding that it was discovered that her heart was functioning only around 45 per cent as opposed to 80 per cent as it would, in a healthy human being.

According to Dr. Paranamana while the reason was found to be inexplicable, with the passing of time, her condition deteriorated. Dr. Paranamana says, in six months the functioning of the heart reduced to 30 per cent, and then 15 per cent in yet another three months, and at the time of the surgery it was functioning only around 10 per cent.

“There was no other solution to her condition than a heart transplant,” he says adding that the transplant took place when every option to save her life had been exhausted.

Pioneering surgery

The complex surgery was performed on July 7 at the Kandy Teaching Hospital with the participation of a large number of medical experts and support staff.

The surgery had commenced at 7 pm on the day with the heart being harvested by Dr. Anil Abeywickrama, the Consultant Cardiac Surgeon of Teaching Hospital, Kandy, while the transplant was conducted by Cardiac Surgeon Dr. Muditha Lansakara and Dr. K. Gnakanthan. Cardiologist Dr. Sunethra Irugalbandara had been in charge of organ care while Dr. Jagathi Perera provided anaesthesia for the pioneering operation.

After an eight hour long surgery, the transplanted heart had begun to beat as normal, three hours after the surgery was performed, with the transplant patient still under observation. According to Dr. Ratnayake, Director KTH, the recipient recovered fast and is being monitored closely.

“The patient will be watched closely during the possible rejection period,” he said, adding that the transplanted heart is functioning as in a normal post surgery case. “I consider this surgery a success and that it will open the door to many more such transplants in the future,” he says.

According to Dr. Anil Abeywickrama the feat was only possible through the efforts of all the staff who strove to work as a team to make the surgery a success. “The team had around 50 members including all the hospital support staff,” he says.

The surgery was a result of the hard work of the team spanning a number of years.

“Despite taking 50 years to perform such a surgery we were able to do so with a fully local team,” he says, pointing out, that itself is a major achievement for the country’s medical fraternity. While observing that there are a large number of patients requiring heart transplants in the country, he says, the surgery has brought a sense of hope to them.

“I believe the success of this surgery is a relief to them as now they have a possible second chance at life as well,” he says.

While stressing that aftercare to ensure non-rejection of the heart by the patient is of utmost importance now, Dr. Ratnayake says around nine other patients are awaiting possible heart transplants now in the Kandy Teaching Hospital.

“We will attempt to find matches for patients and perform more transplant surgeries in the future”

The heart transplant in progress at the Kandy Teaching Hospital

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